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117. A crossover, controlled study comparing pergolide with bromocriptine as an adjunct to levodopa for the treatment of Parkinson's disease

Author

Pezzoli, G., primary, Martignoni, E., additional, Pacchetti, C., additional, Angeleri, V., additional, Lamberti, P., additional, Muratorio, A., additional, Bonuccelli, U., additional, De Mari, M., additional, Foschi, N., additional, Cossutta, E., additional, Nicoletti, F., additional, Giammona, G., additional, Canesi, M., additional, Scarlato, G., additional, Caraceni, T., additional, and Moscarelli, E., additional

Published
1995
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118. Pergolide compared with bromocriptine in Parkinson's disease: A multicenter, crossover, controlled study

Author

Pezzoli, G., primary, Martignoni, E., additional, Pacchetti, C., additional, Angeleri, V. A., additional, Lamberti, P., additional, Muratorio, A., additional, Bonuccelli, U., additional, De Mari, M., additional, Foschi, N., additional, Cossutta, E., additional, Nicoletti, F., additional, Giammona, F., additional, Canesi, M., additional, Scarlato, G., additional, Caraceni, T., additional, and Moscarelli, E., additional

Published
1994
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129. Active music therapy in Parkinson's disease: an integrative method for motor and emotional rehabilitation.

Author

Pacchetti, Claudio, Mancini, Francesca, Aglieri, Boberto, Fundaro, Cira, Martignoni, Emilia, Nappi, Giuseppe, Pacchetti, C, Mancini, F, Aglieri, R, Fundarò, C, Martignoni, E, and Nappi, G

Abstract

Background: Modern management of Parkinson's disease (PD) aims to obtain symptom control, to reduce clinical disability, and to improve quality of life. Music acts as a specific stimulus to obtain motor and emotional responses by combining movement and stimulation of different sensory pathways. We explored the efficacy of active music therapy (MT) on motor and emotional functions in patients with PD.Methods: This prospective, randomized, controlled, single-blinded study lasted 3 months. It consisted of weekly sessions of MT and physical therapy (PT). Thirty-two patients with PD, all stable responders to levodopa and in Hoehn and Yahr stage 2 or 3, were randomly assigned to two groups of 16 patients each. We assessed severity of PD with the Unified Parkinson's Disease Rating Scale, emotional functions with the Happiness Measure, and quality of life using the Parkinson's Disease Quality of Life Questionnaire. MT sessions consisted of choral singing, voice exercise, rhythmic and free body movements, and active music involving collective invention. PT sessions included a series of passive stretching exercises, specific motor tasks, and strategies to improve balance and gait.Results: MT had a significant overall effect on bradykinesia as measured by the Unified Parkinson's Disease Rating Scale (p < .034). Post-MT session findings were consistent with motor improvement, especially in bradykinesia items (p < .0001). Over time, changes on the Happiness Measure confirmed a beneficial effect of MT on emotional functions (p < .0001). Improvements in activities of daily living and in quality of life were also documented in the MT group (p < .0001). PT improved rigidity (p < .0001).Conclusions: MT is effective on motor, affective, and behavioral functions. We propose active MT as a new method for inclusion in PD rehabilitation programs. [ABSTRACT FROM AUTHOR]

Published
2000

131. Medical healthcare use in Parkinson's disease: survey in a cohort of ambulatory patients in Italy

Author

Cosentino, Marco, Martignoni, EMILIA SILVANA, Michielotto, D, Calandrella, D, Leoni, O, Riboldazzi, G, Pacchetti, C, Lecchini, Sergio, Nappi, G, and Frigo, G.

Subjects
Adult, Male, medicine.medical_specialty, Office Visits, Electric Stimulation Therapy, Comorbidity, Disease, Drug Prescriptions, Health administration, Antiparkinson Agents, Levodopa, Health care, medicine, Humans, Dementia, Medical prescription, Aged, Patient Care Team, business.industry, lcsh:Public aspects of medicine, Public health, Health Policy, lcsh:RA1-1270, Parkinson Disease, Health Services, Middle Aged, medicine.disease, Hospitalization, Cross-Sectional Studies, Italy, Neurology, Utilization Review, Emergency medicine, Ambulatory, Cohort, Physical therapy, Female, business, Research Article
Abstract

Background Parkinson's disease (PD) is a chronic neurodegenerative disease which at present has no cure, and it usually results in severe disability. The burden of PD increases as the illness progresses, resulting in the extensive utilisation of both health and community services. Knowledge of healthcare use patterns and of their determinants may greatly contribute to improve patient care, however few studies have examined this issue in PD. The present study was devised to describe the type of and reasons for medical healthcare resource use in persons with PD attending a Centre for PD and Movement Disorders, and to examine drug prescriptions issued on such occasions. Methods The study was a retrospective, cross-sectional survey in a cohort of ambulatory patients with PD, conducted by means of standard interviews. Results In the year before the study, 92 (70.8%) of 130 patients used medical healthcare resources: 1/5 of the patients was admitted to hospital, 1/5 to emergency room, 2/5 were visited by a non-neurology specialist, and 1/4 by the GP. Reasons were: nearly 20% programmed hospital admissions and visits, and more than 25% injuries and musculo-skeletal diseases. Other conditions typically occurring in PD (e.g. dementia, diabetes and cardio- and cerebro-vascular disease) were less frequently involved. On such occasions, drugs for PD were occasionally changed, however drug prescriptions for other indications were issued to more than 66% of the patients. Conclusion Several physicians other than the neurologist may take care of PD patients on different occasions, thus emphasising the need for communication between the reference neurologist and other physicians who from time to time may visit the patient.

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137. Active music therapy and parkinson's disease: Methods

Author

Pacchetti, C., Aglieri, R., Mancini, F., Martignoni, E., and Giuseppe Nappi

Subjects
Male, Surveys and Questionnaires, Emotions, Quality of Life, Humans, Female, Parkinson Disease, Prospective Studies, Middle Aged, Music Therapy, Aged
Abstract

Music therapy (MT) is an unconventional, multisensorial therapy poorly assessed in medical care but widely used to different ends in a variety of settings. MT has two branches: active and passive. In active MT the utilisation of instruments is structured to correspond to all sensory organs so as to obtain suitable motor and emotional responses. We conducted a prospective study to evaluate the effects of MT in the neurorehabilitation of patients with Parkinson's Disease (PD), a common degenerative disorder involving movement and emotional impairment. Sixteen PD patients took part in 13 weekly sessions of MT each lasting 2 hours. At the beginning and at the end of the session, every 2 weeks, the patients were evaluated by a neurologist, who assessed PD severity with UPDRS, emotional functions with Happiness Measures (HM) and quality of life using the Parkinson's Disease Quality of Life Questionnaire (PDQL). After every session a significant improvement in motor function, particularly in relation to hypokinesia, was observed both in the overall and in the pre-post session evaluations. HM, UPDRS-ADL and PDQL changes confirmed an improving effect of MT on emotional functions, activities of daily living and quality of life. In conclusion, active MT, operating at a multisensorial level, stimulates motor, affective and behavioural functions. Finally, we propose active MT as new method to include in PD rehabilitation programmes. This article describes the methods adopted during MT sessions with PD patients.

141. The position of the head in space: A kinematic analysis in patients with cervical dystonia treated with botulinum toxin

Author

Albani, G., Bulgheroni, M. V., Mancini, F., Mauro, A., Cira Fundarò, Pacchetti, C., Sandrini, G., and Nappi, G.

Subjects
Adult, Male, Botulinum Toxins, Treatment Outcome, Anti-Dyskinesia Agents, Posture, Humans, Female, Middle Aged, Head, Severity of Illness Index, Torticollis, Biomechanical Phenomena
Abstract

Many instruments have been employed in recent years in order to quantify the posture and motion of the head in normal and pathological subjects. Evaluations of this type present many difficulties related to the influence of individual and external factors and to the accuracy of the system used. In patients with cervical dystonia (CD) the only rating scales currently used are semi-quantitative and subjective. More precise information on disease severity and response to the treatment is needed. Posture and motion of the head were evaluated by means of ELITE motion analyser (BTS, Milan, Italy) in 6 patients with the left laterocollis form of CD undergoing treatment with botulinum toxin (BTX). The method emerged as very useful for the quantification of the therapeutic response (which was more marked in motion than in posture). We found an inverse relationship between the degree of motion improvement and the restriction of motion before treatment.

144. Pisa syndrome in Parkinson's disease: demographic and clinical correlations in an Italian Multicenter study

Author

Juergenson, I. B., Geroin, C., Bombieri, F., Smania, N., Ottaviani, S., Tommaso Bovi, Bisoffi, G., Mirandola, R., Canesi, M., Pezzoli, G., Ceravolo, R., Frosini, D., Rossi, S., Ulivelli, M., Thomas, A., Di Giacomo, R., Fabbrini, G., Sarchioto, M., Bentivoglio, A., Bove, F., Tamma, F., Lucchese, V., Cossu, G., Di Stefano, F., Pisani, A., Amadeo, G., Modugno, N., Zappia, M., Nicoletti, A., Volonte, M. A., Spagnolo, F., Sciaretta, M., Altavilla, T., Abbruzzese, G., Cordano, C., Pacchetti, C., Pozzi, N. G., Marconi, R., Gallerini, S., Mignarri, A., Allocca, R., Defazio, G., Morgante, F., Riccardi, L., Cannas, A., Solla, P., Vitale, C., Fasano, A., Barone, P., and Tinazzi, M.

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